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General NPI Number Information
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NPI Number | 1144506536
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Entity Type | Organization
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Legal Business Name | LIVING WELL
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Dates
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Enumeration Date | 10/29/2011
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 934 N MAGNOLIA AVE SUITE 119
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City | ORLANDO
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State | FL
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Zip | 32803-3840
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Country | US
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Telephone | 407-718-5380
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 560182
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City | ORLANDO
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State | FL
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Zip | 32856-0182
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Country | US
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Telephone | 407-718-5380
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/CEO
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Name | ANDREA JACQUELINE GARWOOD
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Credential | LMHC
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Telephone | 407-718-5380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 5144
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License Number State | FL
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